Nursing Elites

1. When caring for a child with probable appendicitis, the nurse should be alert to recognize which sign or symptom as a manifestation of perforation?

• A. Anorexia
• B. Bradycardia
• C. Sudden relief from pain
• D. Decreased abdominal distention

Correct answer: C

Rationale: When caring for a child with probable appendicitis, sudden relief from pain is a critical sign that could indicate perforation of the appendix. Perforation results in the release of pressure and inflammation, leading to a temporary relief of pain. Anorexia (loss of appetite) and decreased abdominal distention are symptoms commonly associated with appendicitis itself, not perforation. Bradycardia (slow heart rate) is not typically a direct manifestation of appendicitis or its complications.

2. What clinical manifestation(s) is associated with calcium depletion (hypocalcemia)?

• A. Nausea, vomiting
• B. Weakness, fatigue
• C. Muscle hypotonicity
• D. Neuromuscular irritability

Correct answer: D

Rationale: Hypocalcemia can lead to neuromuscular irritability, causing symptoms such as muscle cramps, tetany, or seizures. Other symptoms like nausea, vomiting, and weakness are less specific and can be related to various conditions.

3. Which developmental milestone would the nurse expect an 11-month-old infant to have achieved?

• A. Sitting independently
• B. Turning a doorknob
• C. Building a tower of four cubes
• D. Walking independently

Correct answer: A

Rationale: The correct answer is A: Sitting independently. By 11 months, most infants can sit independently. This milestone usually precedes walking, which typically occurs closer to 12 months. Turning a doorknob and building a tower of four cubes involve more complex motor skills that are typically achieved later in development. Therefore, at 11 months, sitting independently is the milestone that the nurse would expect an infant to have achieved.

4. A mother reports to the nurse that her 6-year-old child is highly active, irritable, irregular in habits, and adapts slowly to new routines, people, or situations. Which pattern of temperament would best describe the child?

• A. The 'easy' child
• B. The 'difficult' child
• C. The 'slow-to-warm-up' child
• D. The 'fast-to-warm-up' child

Correct answer: B

Rationale: The 'difficult' child is the best way to describe the child in this scenario. This temperament is characterized by high activity levels, irritability, irregular habits, and difficulty adapting to changes. Choice A, the 'easy' child, is known for being generally positive and adaptable. Choice C, the 'slow-to-warm-up' child, typically needs time to adapt to new situations but is not necessarily highly active or irritable. Choice D, the 'fast-to-warm-up' child, adapts quickly to new situations, which contrasts with the child's slow adaptation mentioned in the scenario.

5. In teaching parents about appropriate pacifier selection, the nurse should recommend which characteristic?

• A. Easily grasped handle
• B. Detachable shield for cleaning
• C. Soft, pliable material
• D. Ribbon or string to secure to clothing

Correct answer: A

Rationale: A pacifier with an easily grasped handle is safer and more convenient for the infant to use without the risk of choking hazards that detachable parts might pose.

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